Active surveillance:A treatment plan that involves closely watching a patient’s condition but not giving any treatment unless there are changes in test results that show the condition is getting worse. Active surveillance may be used to avoid or delay the need for treatments such as radiation therapy or surgery, which can cause side effects or other problems. During active surveillance, certain exams and tests are done on a regular schedule. It may be used in the treatment of certain types of cancer, such as prostate cancer, urethral cancer, and intraocular (eye) melanoma. It is a type of expectant management.
AUA: (American Urological Association): The official society of American urologists.
Biochemical recurrence: (BCR): Treatment relapse in which the PSA blood levels rise in a man with prostate cancer. The same as PSAR.
Biomarker: is a biological marker, which may be used as an indicator of a specific biological state or condition.
Biopsy: the removal of cells or tissues for examination by a pathologist.
CT scan: Computed Tomography is an imaging procedure that uses special x-ray equipment to create a series of detailed pictures, or scans, of areas inside the body. In prostate cancer, CT may be used to provide information about the extent, or stage, of disease or to monitor for recurrence.
Confidence interval (CI): Quantifies the uncertainty in measurement. It is usually reported as 95% CI, which is the range of values within which we can be 95% sure that the true value for the whole population lies. For example, for a Number Needed to Treat (NNT) of 10 with a 95% CI of 5 to 15, we would have 95% confidence that the true NNT value was between 5 and 15.
Extraprostatic extension: When the tumor extends outside of the prostate. See T3 disease.
Genes: Hereditary units that carry instructions for making proteins which direct the activities of cells and functions of the body that influence traits such as hair and eye color.
Genetics: The science of inheritance concerned with how biological traits (genes) are passed down from one generation to another.
Genome: The human genome is the complete set of genetic information for humans and includes both protein-coding genes and noncoding regions.
Genomics: Refers to the study of the entire genome of an organism whereas genetics refers to the study of a particular gene
Gleason grade: A widely used method for classifying prostate cancer tissue for the degree of loss of the normal glandular architecture (size, shape and differentiation of glands); a grade from 1–5 is assigned successively to each of the two most predominant tissue patterns present in the examined tissue sample and are added together to produce the Gleason score; high numbers indicate poor differentiation and therefore more aggressive cancer.
Gleason score: Two Gleason Grade numbers are added together to produce the Gleason score. A Gleason score can range from 2 to 10. The first Gleason Grade number indicates the Gleason Grade of the cancer cells found most commonly within the sample, the second number represents the second most commonly found grade. For example, a Gleason Score of 4+3=7 means that Gleason Grade 4 is the predominant tissue pattern and Gleason Grade 3 is the second most commonly found pattern, producing a total Gleason Score of 7. Higher Gleason scores are associated increased cancer aggressiveness.
Histology: The study of cells and tissues under the microscope.
Hormone therapy: Also called hormonal therapy is the use of hormone medications to treat cancer patients by removing, blocking, or adding to the effects of a hormone on an organ or part of the body. Hormone therapy may also include surgical removal of the testicles to prevent male hormones from further stimulating the growth of prostate cancer.
Intensity modulated radiation therapy (IMRT): Radiation therapeutic approach which specifies the tumor target dose and the amount of radiation allowable to the nearby tissues and uses sophisticated computer planning and that allows the radiation intensity to be modulated up or down as the delivery system rotates around the patient.
Lymph Nodes: Network of glands in the lymphatic system.
Metastasis: a secondary tumor formed as a result of a cancer cell or cells from the primary tumor site (e.g., the prostate) traveling through the body to a new site and then growing there.
Metastasize: Spread of a malignant tumor to other parts of the body.
NCCN (National Comprehensive Cancer Network): a not-for-profit alliance of 26 of the world’s leading cancer centers.
Number needed to treat (NNT): The inverse of the absolute risk reduction and the number of patients that need to be treated to prevent one bad outcome.
Non-coding RNAs (ncRNAs): Refers to a class of genes that are transcribed into RNA but not translated into protein. Rather, they perform specialized regulatory functions within the body. ncRNAs are involved in many biological processes and are increasingly seen as important.
Nomogram: A chart representing numerical relationships.
Outcome: assesses the end result of a treatment or course of action for a patient.
Positive margin: The pathologic finding of cancer cells on the outer edge of the surgically removed tissue.
Prostate-specific antigen (PSA): An antigen made by the prostate gland and found in the blood. High PSA levels may indicate infection, benign prostatic hyperplasia (BPH) or cancer in the prostate gland.
PSA: see Prostate-specific antigen.
PSA kinetics: The term PSA kinetics describes the changes in PSA over time and typically refers to PSA velocity or PSA doubling time. PSA kinetics is important for understanding the prognosis in men with advanced prostate cancer.
PSA recurrence (PSAR): See BCR.
pT3 disease: Refers to the prostate cancer disease stage where the tumor extends outside the prostate. pT3 disease can either be T3a (cancer has spread to the connective tissue near the prostate) or pT3b (the cancer has also spread to the seminal vesicles.)
Pathologic: relating to the medical practice of pathology.
Prognosis: A prediction of the probable outcome of a disease based on a individual’s condition and the usual course of the disease as seen in similar situations.
Prostate: A sex gland in men. It is about the size of a walnut, and surrounds the neck of the bladder and urethra, the tube that carries urine from the bladder. It is partly muscular and partly glandular, with ducts opening into the prostatic portion of the urethra. It is made up of three lobes: a center lobe with one lobe on each side.
Prostate cancer: The most common form of cancer in American men and the second leading cause of cancer death in men.
RNA (Ribonucleic acid): One of the two types of nucleic acids found in all cells. The other is deoxyribonucleic acid (DNA). If DNA is the blueprint for new construction, RNA are the messages that tell cellular machinery which proteins need to be made.
Radical Prostatectomy: Open surgical removal of the entire prostate and the seminal vesicles. The incision is made in the lower abdomen.
Radiographic imaging: This specific type of imaging is generally used in the evaluation of metastatic disease. Most skeletal metastases from prostate cancer are visible on a radionuclide bone scan.
Recurrence: the reappearance of disease after treatment. In the case of prostate cancer, recurrence can be biochemical recurrence (PSA rise), sometimes followed by clinical recurrence (metastases).
Seminal vesicles: The seminal gland, also called the seminal vesicle sits near the prostate and holds the liquid that mixes with sperm to form semen.
Seminal vesicle invasion: tumor growth out of the prostate and into the seminal vesicles.
Specimen: sample of tissue obtained from the prostate that is used to provide the RNA necessary to run the Decipher assay.
Surgical margins: The edge of the tissue removed in prostate cancer surgery. The margin is described as a negative or clean margin when no cancer cells are found at the edge of the tissue; this suggests that the cancer was removed. But, the margin is labeled positive when cancer cells are found at the edge of the removed tissue; this suggests that all of the cancer has not been removed during surgery (see positive surgical margin).
Transcriptome: The transcriptome differs from the genome in that the genome is the entire DNA instruction set of the organism. In order for the instructions encoded in the DNA sequence to be implemented, the DNA must be transcribed into complementary molecules of ribonucleic acid (RNA), which are referred to as transcripts. A transcriptome is a collection of all the transcripts present in a cell.
Tumor: Cells in the body normally divide (reproduce) only when new cells are needed. Sometimes, cells will divide for no reason, creating a mass of tissue called a tumor. Tumors can be benign (not cancer) or malignant (cancer). Prostate cancer is a malignant tumor.